Universidade Federal do Paraná, Hospital de Clínicas, Programa de Pós-Graduação em Medicina Interna, Departamento de Clínica Médica, Curitiba PR, Brazil.
Clínica de Neurologia São José, São José dos Pinhais PR, Brazil.
Arq Neuropsiquiatr. 2022 May;80(5):482-489. doi: 10.1590/0004-282X-ANP-2021-0095.
Migraine pain location and trigeminocervical convergence have limited diagnostic value and have usually been assessed using non-standard verbal descriptors in a small number of centers.
To use non-verbal descriptors of migraine pain location to determine the prevalence of trigeminocervical convergence mechanisms in patients with episodic and chronic migraine. In addition, we explored the factors associated with the presence of convergence.
A multicenter study was carried out. The explicit pain location was explored by asking subjects to indicate, on an electronic form, three points on the anterolateral side and three points on the posterolateral side of the head and neck that represented the common locations of their migraine pain. We evaluated associations of the pain pattern with demographic and psychological features, comorbidities, lifestyle and other headache characteristics.
97 episodic and 113 chronic migraine patients were included. Convergence was present in 116 migraineurs (55%) who indicated dominance of pain in the posterior cervical region. This site was more often involved in the chronic migraine group (21 vs. 33%; p=0.034). The number of migrainous/altered sensitivity symptoms (OR=1.39; 95%CI 1.14-1.71) was associated with convergence independently of the chronification status. In this symptom group, there were statistical associations between convergence and vomiting (p=0.045), tactile allodynia (p<0.001), nuchal rigidity (p<0.001) and movement allodynia (p=0.031).
Trigeminocervical convergence is common in migraineurs and, in practice, it might be found frequently in chronic migraineurs. Some features commonly found in this group, such as altered sensitivity symptoms, are associated with this phenomenon.
偏头痛疼痛部位和三叉颈汇聚的诊断价值有限，通常在少数中心使用非标准的口头描述进行评估。
使用偏头痛疼痛部位的非口头描述来确定发作性和慢性偏头痛患者三叉颈汇聚机制的患病率。此外，我们还探讨了与汇聚存在相关的因素。
进行了一项多中心研究。通过要求受试者在电子表格上指出头颈部前外侧和后外侧的三个点，以明确表示其偏头痛疼痛的常见部位，从而探索明确的疼痛位置。我们评估了疼痛模式与人口统计学和心理学特征、合并症、生活方式和其他头痛特征的关联。
纳入了 97 例发作性偏头痛患者和 113 例慢性偏头痛患者。116 例偏头痛患者（55%）存在汇聚，表现为后颈部疼痛为主。该部位在慢性偏头痛组中更为常见（21%比 33%；p=0.034）。偏头痛/感觉改变症状的数量（OR=1.39；95%CI 1.14-1.71）与汇聚独立相关，与慢性化状态无关。在这个症状组中，汇聚与呕吐（p=0.045）、触觉超敏（p<0.001）、项部僵硬（p<0.001）和运动超敏（p=0.031）之间存在统计学关联。
三叉颈汇聚在偏头痛患者中很常见，实际上在慢性偏头痛患者中可能经常发现。该组中一些常见的特征，如感觉改变症状，与这种现象相关。
